Spearman Rs Research Articles

Comparison of Lipid and Protein Oxidation Products and their Impact on Colour Stability in Bison Longissimus Lumborum and Psoas Major Muscles

ObjectivesTo compare lipid (malondialdehyde [MDA], 4-hydroxy-2-nonenal [HNE]) and protein (carbonyl content [CAR]) oxidation products and determine their influence on color stability in two bison muscles (longissimus lumborum [LL; color stable] and psoas major [PM; color labile]).Materials and MethodsA total of 10 longissimus lumborun (LL) and 10 psoas major (PM) from five A1 grade bison carcasses were obtained from a commercial slaughter plant within 48 h post-mortem. From each muscle, a 10-cm thick piece was removed and subsampled for evaluation of pH, MDA (by thiobarbituric acid assay), HNE (by ELISA) and CAR (by 2,4-dinitrophenylhydrazine). These measurements allowed the establishment of a baseline for the different oxidation products. The remainder of the muscles were cut into two equal portions, and each portion was vacuum-packaged and assigned to an ageing period of 7 and 14 d at 2°C. At the end of each ageing period, each muscle portion was removed from their packages, pH measured, and steaks obtained for sensory (muscle and discoloration scores) and instrumental color measurements (L*, a* and b*) over 5 d of retail display, and for estimation of MDA, HNE and CAR. After 5 d in retail display and following color and pH measurements the steaks were removed and collected for MDA, HNE and CAR determination. Data were analyzed as a completely randomized design with a split-split plot arrangement. Additionally, correlation and regression analysis were performed to identify the influence of the measured attributes on color.ResultsRegardless of the ageing time, LL showed greater redness and lower surface discoloration by instrumental (a* value; P = 0.04) and sensory (P < 0.01) color evaluation than PM at the end of the retail display. Furthermore, LL exhibited lower MDA, HNE and CAR content compared to PM (P < 0.05). A three-way interaction (muscle × ageing time × retail day display) was detected on MDA content, where PM presented a higher level of MDA with increasing ageing time and retail display than LL (P = 0.02). The pH was not different between LL and PM (P > 0.05) steaks.In both muscles, Pearson (r) and Spearman (rs) correlation coefficients indicated that MDA was the oxidation compound showing the highest correlation to a* (r = –0.78; P < 0.01) and discoloration (rs = 0.81; P < 0.01) scores, followed by a moderate correlation with HNE and CAR (r or rs < 0.7; P < 0.01). The pH did not exhibit correlation with color traits, except for lightness, in both muscles. For the stepwise regression analysis, the main variable entered into the equation for predicting a*, color and discoloration score in PM muscle was MDA with an R2 of 0.72, 0.75 and 0.78, respectively, while for LL muscle, MDA presented an R2 of 0.62, 0.68 and 0.66;, respectively. The pH, HNE and CAR only explained an additional 2% of the variation in those attributes.ConclusionThe results of color attributes corroborated that bison LL is a color-stable muscle due to the lower level of protein and lipid oxidation products developed during storage and retail display compared to PM muscle, which is considered color-labile muscle. The MDA seemed to have remarkable importance in the color deterioration than HNE and CAR, particularly in bison PM muscle.

Prognostic value of the oxygenation index to predict survival and timing of surgery in infants with congenital diaphragmatic hernia

AimsTo compare the mean oxygenation index on day1 (MOId1) with the best OI on day1 (BOId1) in predicting 30-day mortality in congenital diaphragmatic hernia (CDH). In addition, to determine whether serial OIs in the first 48 h after birth and preoperative OI (PreOp-OI), were associated with optimal timing of surgery, ventilation requirement and hospital stay in infants with CDH. MethodsThe medical records of infants with antenatally diagnosed CDH during 2009–2015 were retrospectively reviewed. Receiver operator characteristic curves were constructed to identify MOId1 and BOId1 cutoff levels to predict 30-day mortality. In those who underwent surgery, the mean OI on each of the first two days (MOId1, MOId2) and PreOp-OI were correlated using Spearman (rs) with the age at surgery, the duration of ventilation and length of stay. Statistical significance was P < 0.05* and < 0.001**. ResultsSurvivors (n = 44) and nonsurvivors (n = 24) were comparable in gestational age, birth weight and defect laterality. Nonsurvivors had higher median BOId1 (15.4 vs 2.9; P < 0.01) and MOId1 (48 vs 7.5; p < 0.01) than survivors. Mortality was best predicted by two cutoffs [BOId1 > 6 (sensitivity 92%, specificity 89%); and MOId1 > 17 (sensitivity 96%, specificity 96%)].Forty-four infants underwent surgery at a median postnatal age of five (range 2–19) days. MOId1 and MOId2 both correlated significantly with the age at surgery (rs = 0.4**, rs 0.5**) but not ventilation period and length of stay. PreOp-OI correlated significantly with age at surgery, duration of ventilation and length of stay (rs = 0.32*, rs = 0.47**, rs = 0.37*). A PreOp-OI <3 was predictive of optimal timing for surgery with improved duration of ventilation (8 vs 22, P = 0.001) and length of stay (26 vs 47, P = 0.004). However, 11/44 (25%) patients would not achieve a PreOp-OI < 3 by day 7+ of life and might still require surgery, one of them died. ConclusionBoth MOId1 and BOId1 are highly predictive of mortality in CDH. Oxygenation indices in the first 48 h poorly predicted the timing of surgery. PreOp-OI <3 may be a cutoff for optimal timing for surgery in infants for CDH repair. Type of studyPrognostic Study. Level of evidenceLevel III.

Minor differences were found between AMSTAR 2 and ROBIS in the assessment of systematic reviews including both randomized and nonrandomized studies

ObjectiveTo compare A Measurement Tool to Assess Systematic Reviews (AMSTAR 2) with a tool to assess risk of bias in systematic reviews (ROBIS) in terms of validity, reliability, and applicability. Study Design and SettingWe analyzed 30 systematic reviews (SRs) that included randomized and nonrandomized studies, with Cochrane and non-Cochrane SRs sampled in 1:1 ratio. Four reviewers assessed independently all 30 SRs with AMSTAR 2, followed by ROBIS. We calculated Fleiss’ Kappa as a measure of inter-rater reliability (IRR) across 4 raters. ResultsThe IRR for scoring the overall confidence in the SRs with AMSTAR 2 and the overall domain in ROBIS was fair (AMSTAR 2: κ = 0.30, 95% [confidence interval] CI: 0.17 to 0.43; ROBIS: κ = 0.28, 95% CI: 0.13 to 0.42). AMSTAR 2 confidence in review ratings strongly correlated with the overall domain rating in ROBIS (Spearman rs = 0.84). Mean time for scoring AMSTAR 2 was slightly higher than for ROBIS (18 vs. 16 min), with huge differences between the reviewers. ConclusionBoth AMSTAR 2 and ROBIS can be applied to SRs including both randomized controlled trials (RCTs) and non-RCTs. Measurement properties of ROBIS seemed not to be much different when comparing with other studies that include only SRs of RCTs.

Homology models of mouse and rat estrogen receptor-α ligand-binding domain created by in silico mutagenesis of a human template: Molecular docking with 17β-estradiol, diethylstilbestrol, and paraben analogs

Crystal structures exist for human, but not rodent, estrogen receptor-α ligand-binding domain (ERα-LBD). Consequently, rodent studies involving binding of compounds to ERα-LBD are limited in their molecular-level interpretation and extrapolation to humans. Because the sequences of rodent and human ERα-LBDs are >95% identical, we expected their 3D structures and ligand binding to be highly similar. To test this hypothesis, we used the human ERα-LBD structure (PDB 3UUD) as a template to produce rat and mouse homology models. Employing the rodent models and human structure, we generated docking poses of 23 Group A ligands (17β-estradiol, diethylstilbestrol, and 21 paraben analogs) in AutoDock Vina for interspecies comparisons. Ligand RMSDs (Å) (median, 95% CI) were 0.49 (0.21–1.82) (human-mouse) and 1.19 (0.22–1.82) (human-rat), well below the 2.0–2.5 Å range for equivalent docking poses. Numbers of interspecies ligand-receptor residue contacts were highly similar, with Sorensen Sc (%) = 96.8 (90.0–100) (human-mouse) and 97.7 (89.5–100) (human-rat). Likewise, numbers of interspecies ligand-receptor residue contacts were highly correlated: Pearson r = 0.913 (human-mouse) and 0.925 (human-rat). Numbers of interspecies ligand-receptor atom contacts were even more tightly correlated: r = 0.979 (human-mouse) and 0.986 (human-rat). Pyramid plots of numbers of ligand-receptor atom contacts by residue exhibited high interspecies symmetry and had Spearman rs = 0.977 (human-mouse) and 0.966 (human-rat). Group B ligands included 15 ring-substituted parabens recently shown experimentally to exhibit decreased binding to human ERα and to exert increased antimicrobial activity. Ligand efficiencies calculated from docking ligands into human ERα-LBD were well correlated with those derived from published experimental data (Pearson partial rp = 0.894 and 0.918; Groups A and B, respectively). Overall, the results indicate that our constructed rodent ERα-LBDs interact with ligands in like manner to the human receptor, thus providing a high level of confidence in extrapolations of rodent to human ligand-receptor interactions.

Motor variables correlated with the hand-to-mouth maneuver in stroke patients.

This study investigated the relationship between each of three independent variables and the completion of the hand-to-mouth maneuver in 23 hemiparetic stroke patients. The independent variables were elbow-extensor muscle tone (graded using the Modified Ashworth Scale); active elbow-flexion range-of-motion deficit measured without the influence of gravity; and elbow-flexion strength measured without the influence of gravity with a hand-held dynamometer. The hand-to-mouth maneuver was graded according to the degree of completion using a three-level ordinal scale. Spearman (rs) correlations demonstrated a significant relationship between the extent of completion of the hand-to-mouth maneuver and both the active elbow-flexion-range deficit (rs = -.853) and the elbow-flexor muscle force (rs = .829). The correlation of the maneuver with elbow-extensor muscle tone (rs = -.063) was not significant, but the relationship may have been influenced by the fact that only a minority of subjects had elevated tone, and that elevation was minimal. The result suggest that both active-movement deficits and muscle strength may be important to upper extremity function.

Intra- and interday reliability of the dynamic navicular rise, a new measure for dynamic foot function: A descriptive, cross-sectional laboratory study

BackgroundThe lack of reliable parameters to evaluate dynamic foot function, emphasizes the need for a deeper insight in foot biomechanics. The aims were to investigate the reliability of a new parameter (dynamic navicular rise dNR), and its relationship with the dynamic navicular drop (dND). MethodsTwenty healthy participants (mean age 30.2±8.1years) had to walk on even ground and downstairs. Data of ten trials per task on two measurement days were recorded. The dNR was defined as the difference in millimetres (mm) between the minimum navicular height (NH) during stance and the NH at toe off. To test intra- and interday reliability, Intraclass Correlation Coefficients (ICC2.1) and repeatability were calculated. To obtain the absolute repeatability (RP) in mm, the equation RP=1.96×SDdifferences was used. Furthermore, the relationship between the dNR and the dND was examined by calculating Pearson (r) or Spearman (rs) correlation coefficients. ResultsIncluded participants showed a mean dNR of (12.2±3.7) mm for level walking and (14.8±3.4) mm for stair descent. The ICC2.1 for the dNR were 0.98 (intraday), 0.91 (interday) for level walking and 0.97 (intraday), 0.94 (interday) for stair descent. The interday repeatability was 3.2mm (level walking), 2.7mm (stair descent) respectively. For level walking, r was 0.31 (p=0.049), and rs=0.88 (p<0.001) for stair descent. ConclusionsThe dNR seems to be highly reliable (ICCs), however, repeatability is unacceptable. For level walking, the dNR might be an independent measure, but not for stair climbing.

KIR3DL1-Negative CD8 T Cells and KIR3DL1-Negative Natural Killer Cells Contribute to the Advantageous Control of Early Human Immunodeficiency Virus Type 1 Infection in HLA-B Bw4 Homozygous Individuals.

Bw4 homozygosity in human leukocyte antigen class B alleles has been associated with a delayed acquired immunodeficiency syndrome (AIDS) development and better control of human immunodeficiency virus type 1 (HIV-1) viral load (VL) than Bw6 homozygosity. Efficient CD8 T cell and natural killer (NK) cell functions have been described to restrain HIV-1 replication. However, the role of KIR3DL1 expression on these cells was not assessed in Bw4-homozygous participants infected with HIV-1 CRF01_A/E subtype, currently the most prevalent subtype in China. Here, we found that the frequency of KIR3DL1-expressing CD8 T cells of individuals homozygous for Bw6 [1.53% (0–4.56%)] was associated with a higher VL set point (Spearman rs = 0.59, P = 0.019), but this frequency of KIR3DL1+CD8+ T cells [1.37% (0.04–6.14%)] was inversely correlated with CD4 T-cell count in individuals homozygous for Bw4 (rs = −0.59, P = 0.011). Moreover, CD69 and Ki67 were more frequently expressed in KIR3DL1−CD8+ T cells in individuals homozygous for Bw4 than Bw6 (P = 0.046 for CD69; P = 0.044 for Ki67), although these molecules were less frequently expressed in KIR3DL1+CD8+ T cells than in KIR3DL1−CD8+ T cells in both groups (all P < 0.05). KIR3DL1−CD8+ T cells have stronger p24-specific CD8+ T-cell responses secreting IFN-γ and CD107a than KIR3DL1+CD8+ T cells in both groups (all P < 0.05). Thus, KIR3DL1 expression on CD8 T cells were associated with the loss of multiple functions. Interestingly, CD69+NK cells lacking KIR3DL1 expression were inversely correlated with HIV-1 VL set point in Bw4-homozygous individuals (rs = −0.52, P = 0.035). Therefore, KIR3DL1−CD8+ T cells with strong early activation and proliferation may, together with KIR3DL1−CD69+NK cells, play a protective role during acute/early HIV infection in individuals homozygous for Bw4. These findings highlight the superior functions of KIR3DL1−CD8+ T cells and KIR3DL1−CD69+NK cells being a potential factor contributing to delayed disease progression in the early stages of HIV-1 infection.

Associations between blood lead, olfaction and fine-motor skills in elderly men: Results from the Heinz Nixdorf Recall Study

Lead (Pb) is a recognized neurotoxin. Pb2+ can interfere with divalent metal transporters and ion channels and may thus affect other brain metals and cation signaling in neurons. Thereby, cognitive and sensory functions can be impaired. Whereas cognitive effects are well described less is known about olfaction and motor functions in the general population at currently lower exposure levels. The objective of this study was to evaluate the influence of Pb in blood (PbB) on odor identification and fine motor skills within the framework of the Heinz Nixdorf Recall Study (HNRS), a prospective cohort study among an elderly German population.Data on odor identification assessed with Sniffin’ sticks and fine motor test results were collected during the second follow-up of HNRS (2011–2014) in 1188 elderly men aged 55 to 86 years. PbB was determined in 1140 blood samples archived at baseline (2000–2003) and in 796 samples from the second follow-up. The association between PbB and impaired odor identification (normosmia as reference) was estimated with proportional odds ratios (PORs) with 95% confidence intervals (CI). The odds ratios (OR) of substantially impaired dexterity (tapping hits <10th percentile, errors in aiming, line tracing, or steadiness>90th percentile) were estimated with mixed logistic regression models for test results with both hands, where PbB was adjusted for covariates.PbB at baseline (median 32.9 μg/L; 2.27% ≥90 μg/L) was higher than at follow-up (25.9 μg/L; 0.84% ≥90 μg/L). The individual concentrations were correlated (Spearman rs 0.59, 95% CI 0.54 – 0.63). PORs of an impaired odor identification in men with baseline PbB ≥90 μg/L were 1.96 (95% CI 0.94–4.11) and 1.57 (95% CI 0.47–5.19) with follow-up PbB. Fine-motor tests were not affected by elevated PbB with the exception of tapping in men with follow-up PbB ≥50 μg/L (OR 2.14, 95% CI 1.09–4.23). Increasing age had strong effects on all outcomes. Low education was associated with impaired odor identification, tapping, and aiming. Also, alcohol consumption and current smoking affected the test results, particularly steadiness.In this community-based cohort of elderly men, we could confirm indication of an influence of elevated PbB on odor identification. Small numbers of men with elevated PbB due to an on-going trend of decreasing PbB in the general population, strong covariates and multiple comparisons hamper the evaluation of adversity of these effects of PbB on olfaction and dexterity.

Cisterno-lumbar gradient of complement fractions in geriatric patients with suspected normal pressure hydrocephalus

BackgroundThe complement system is a functional link between the innate and adaptive immune system and present in all compartments of the body. The composition of the cerebrospinal fluid (CSF) differs between the ventricular, cisternal and lumbar space. Usually, concentrations of blood-derived CSF proteins increase from ventricular to lumbar fractions. MethodsIn 20 geriatric patients with suspected normal pressure hydrocephalus (NPH) [13 women, 7 men, age 80.5 (75/85) years; median (25th/75th percentile)] a lumbar spinal tap of 40 ml was performed, and 10 ml of serum was drawn. CSF, sequentially collected in 8 fractions of 5 ml (1st fraction: lumbar CSF; 8th fraction: cisterna magna-near CSF), was analyzed for complement protein C3, and the activation products C3a and sC5b-9 by enzyme immunoassay. ResultsThe concentrations of the complement factors measured in fractions 1 and 8 of each individual patient were strongly correlated: C3 (Spearman's rank correlation coefficient rS = 0.75, p = 0.0002); C3a (rS = 0.93, p < 0.0001); sC5b-9 (rS = 0.64, p = 0.002). CSF complement concentrations were lower in the cistern-near fraction 8 than in the lumbar fraction 1 (C3: p = 0.005; C3a: p = 0.0009; sC5b-9: p = 0.0003, Wilcoxon signed rank test). The concentrations of complement factors in CSF were two orders of magnitude lower than those in serum. C3 levels in the lumbar CSF strongly correlated with the lumbar CSF/serum albumin concentration quotient (QAlb) as a measure of the functionability of the blood-CSF barrier and the velocity of CSF flow (rS = 0.84, p < 0.0001) suggesting diffusion of C3 from blood to CSF. The lumbar and cistern-near concentrations of C3a did not significantly correlate with QAlb (rS = 0.26) pointing to a local conversion of C3 to C3a. The lumbar concentrations of sC5b-9 moderately correlated with QAlb (rS = 0.62, p = 0.004). Plotting the CSF/serum quotient of C3 and sC5b-9 versus the QAlb revealed an approx. 50% local synthesis of C3, but a strong production of sC5b-9 in the CNS. ConclusionsThe increase of the complement concentrations from cisternal to lumbar CSF and the strong correlation of C3 with QAlb suggest that (1) a substantial portion of complement C3 in CSF originates from blood and (2) the complement system is mildly activated in the CSF of NPH patients.

Relationship of the skin and subcutaneous tissue thickness in the tensiomyography response: a novel ultrasound observational study.

The aim of the study was to describe and correlate the skin, subcutaneous tissue, and superficial fascia thickness assessed by ultrasonography (US) with the lumbar erector spinae muscles contractile properties evaluated by tensiomyography (TMG). A cross-sectional descriptive study with 50 healthy participants was performed. The point of maximum lordosis in the lumbar region of the right erector spinae was evaluated by US and TMG. First, the skin, subcutaneous tissue, and superficial fascia thicknesses (cm) were assessed by US. Second, the five contractile TMG parameters were analyzed from the right erector spinae muscles belly displacement-time curves: maximal radial displacement (Dm), contraction time (Tc), sustain time (Ts), delay time (Td), and half-relaxation time (Tr). Finally, correlation analyses using Pearson (r for parametric data) and Spearman (rs for non-parametric data) coefficients were performed. A strong negative correlation was shown between Dm and subcutaneous tissue thickness (rs=-0.668; P<.001). Furthermore, moderate negative correlations were observed between Dm and skin thickness (r=-0.329; P=0.020) as well as Tr and subcutaneous tissue thickness (rs=-0.369; P=0.008). The rest of the parameters did not show statistically significant correlations (P >.05). Therefore, the lumbar erector spinae contractile properties during TMG assessments, especially Dm and Tr, may be widely correlated by the skin and subcutaneous tissue thickness.

Differentiation between malignant and benign musculoskeletal tumors using diffusion kurtosis imaging.

The purpose of this study was to evaluate differences in parameters of diffusion kurtosis imaging (DKI) and minimum apparent diffusion coefficient (ADCmin) between benign and malignant musculoskeletal tumors. In this prospective study, 43 patients were scanned using a DKI protocol on a 3-T MR scanner. Eligibility criteria were: non-fatty, non-cystic soft tissue or osteolytic tumors; >2cm; location in the retroperitoneum, pelvis, leg, or neck; and no prior treatment. They were clinically or histologically diagnosed as benign (n = 27) or malignant (n = 16). In the DKI protocol, diffusion-weighted imaging was performed using four b values (0-2000s/mm2) and 21 diffusion directions. Mean kurtosis (MK) values were calculated on the MR console. A recently developed software application enabling reliable calculation was used for DKI analysis. MK showed a strong correction with ADCmin (Spearman's rs = 0.95). Both MK and ADCmin values differed between benign and malignant tumors (p < 0.01). For benign and malignant tumors, the mean MK values (±SD) were 0.49 ± 0.17 and 1.14 ± 0.30, respectively, and ADCmin values were 1.54 ± 0.47 and 0.49 ± 0.17 × 10-3mm2/s, respectively. At cutoffs of MK = 0.81 and ADCmin = 0.77 × 10-3mm2/s, the specificity and sensitivity for diagnosis of malignant tumors were 96.3 and 93.8% for MK and 96.3 and 93.8% for ADCmin, respectively. The areas under the curve were 0.97 and 0.99 for MK and ADCmin, respectively (p = 0.31). MK and ADCmin showed high diagnostic accuracy and strong correlation, reflecting the accuracy of MK. However, no clear added value of DKI could be demonstrated in differentiating musculoskeletal tumors.

Linking Regional Winter Sea Ice Thickness and Surface Roughness to Spring Melt Pond Fraction on Landfast Arctic Sea Ice

The Arctic sea ice cover has decreased strongly in extent, thickness, volume and age in recent decades. The melt season presents a significant challenge for sea ice forecasting due to uncertainty associated with the role of surface melt ponds in ice decay at regional scales. This study quantifies the relationships of spring melt pond fraction (fp) with both winter sea ice roughness and thickness, for landfast first-year sea ice (FYI) and multiyear sea ice (MYI). In 2015, airborne measurements of winter sea ice thickness and roughness, as well as high-resolution optical data of melt pond covered sea ice, were collected along two ~5.2 km long profiles over FYI- and MYI-dominated regions in the Canadian Arctic. Statistics of winter sea ice thickness and roughness were compared to spring fp using three data aggregation approaches, termed object and hybrid-object (based on image segments), and regularly spaced grid-cells. The hybrid-based aggregation approach showed strongest associations because it considers the morphology of the ice as well as footprints of the sensors used to measure winter sea ice thickness and roughness. Using the hybrid-based data aggregation approach it was found that winter sea ice thickness and roughness are related to spring fp. A stronger negative correlation was observed between FYI thickness and fp (Spearman rs = −0.85) compared to FYI roughness and fp (rs = −0.52). The association between MYI thickness and fp was also negative (rs = −0.56), whereas there was no association between MYI roughness and fp. 47% of spring fp variation for FYI and MYI can be explained by mean thickness. Thin sea ice is characterized by low surface roughness allowing for widespread ponding in the spring (high fp) whereas thick sea ice has undergone dynamic thickening and roughening with topographic features constraining melt water into deeper channels (low fp). This work provides an important contribution towards the parameterizations of fp in seasonal and long-term prediction models by quantifying linkages between winter sea ice thickness and roughness, and spring fp.

18F-FDG PET/CT response in a phase 1/2 trial of nab-paclitaxel plus gemcitabine for advanced pancreatic cancer

BackgroundPositron emission tomography (PET) is poised to become a useful imaging modality in staging and evaluating therapeutic responses in patients with metastatic pancreatic cancer (mPC). This analysis from a phase 1/2 study examined the utility of early PET imaging in patients with mPC treated with nab-paclitaxel plus gemcitabine.MethodsTumors were measured by [18F]2-fluoro-2-deoxyglucose PET/computed tomography (CT) in patients who received nab-paclitaxel 100 (n = 13), 125 (n = 38), or 150 (n = 1) mg/m2 plus gemcitabine 1000 mg/m2 on days 1, 8, and 15 of a 28-day cycle. Lesion metabolic activity was evaluated at baseline and 6 and 12 weeks postbaseline.ResultsFifty-two patients had baseline and ≥1 follow-up PET scan. The median maximum standardized uptake values per pancreatic lesion in the nab-paclitaxel 100 mg/m2 and 125 mg/m2 cohorts were 5.1 and 6.5, respectively. Among patients who had a metabolic response by PET, those who received nab-paclitaxel 125 mg/m2 had a 4-month survival advantage over those who received 100 mg/m2. All patients in the nab-paclitaxel 125 mg/m2 cohort experienced an early complete metabolic response (CMR; 34%) or partial metabolic response (PMR; 66%). In the nab-paclitaxel 125 mg/m2 cohort, investigator-assessed objective response rates were 77% and 44% among patients with a CMR and PMR, respectively, with no correlation between PET and CT response (Spearman rs = 0.22; P = 0.193). Patients in the nab-paclitaxel 125 mg/m2 cohort with a CMR experienced a significantly longer overall survival vs those with a PMR (median, 23.0 vs 11.2 months; P = 0.011), and a significant correlation was found between best percentage change in tumor burden by PET and survival: for each 1% decrease in PET score, the risk of death decreased by 2%.ConclusionsThe majority of primary pancreatic tumors and their metastases were PET avid, and PET effectively measured changes in tumor metabolic activity at 6 and 12 weeks. These results support the antitumor activity of nab-paclitaxel 125 mg/m2 plus gemcitabine 1000 mg/m2 for treating mPC and the utility of PET for measuring treatment response. Treatment response by PET analysis may be considered when evaluating investigational agents in mPC.Trial registrationNCT00398086.

Validation of the French Version of the Edmonton Symptom Assessment System

ContextThe Edmonton Symptom Assessment System (ESAS) is a brief, widely adopted, multidimensional questionnaire to evaluate patient-reported symptoms. ObjectivesThe objective of this study was to define a standard French version of the ESAS (F-ESAS) to determine the psychometric properties in French-speaking patients. MethodsIn a first pilot study, health professionals (n = 20) and patients (n = 33) defined the most adapted terms in French (F-ESAS). In a prospective multicentric study, palliative care patients completed the three forms of F-ESAS (F-ESAS-VI, F-ESAS-VE, and F-ESAS-NU, where VI is visual, VE, verbal, and NU, numerical), the Hospital Anxiety and Depression Scale. All patients had a test-retest evaluation during the same half-day. Standardized distraction material was used between each scale. ResultsOne hundred twenty-four patients were included (mean age [±SD]: 68.3 ± 12; 70 women; 54 men). Test-retest reliability was high for all three F-ESAS, and the correlation between these scales was nearly perfect (Spearman rs = 0.66–0.91; P < 0.05). F-ESAS-VI, F-ESAS-VE, and F-ESAS-NU performed similarly and were equally reliable, although there was a trend toward lower reliability for F-ESAS-VI. Correlation between F-ESAS depression and anxiety and HADS depression and anxiety, respectively, were positive (Spearman rs = 0.38–0.41 for depression; Spearman rs = 0.48–0.57 for anxiety, P < 0.05). Among patients, 59 (48%), 45 (36%), and 20 (16%) preferred to assess their symptoms with F-ESAS-VE, F-ESAS-NU, and F-ESAS-VI, respectively. ConclusionThe F-ESAS is a valid and reliable tool for measuring multidimensional symptoms in French-speaking patients with an advanced cancer. All forms of F-ESAS performed well with a trend for better psychometric performance for F-ESAS-NU, but patients preferred the F-ESAS-VE.

Which Part of the Triceps Surae Muscle Contributes More to Functional Foot Equinus in Spastic Hemiplegic CP Gait?

The lack of reliable parameters to evaluate dynamic foot function, emphasizes the need for a deeper insight in foot biomechanics. The aims were to investigate the reliability of a new parameter (dynamic navicular rise dNR), and its relationship with the dynamic navicular drop (dND).Twenty healthy participants (mean age 30.2 ± 8.1 years) had to walk on even ground and downstairs. Data of ten trials per task on two measurement days were recorded. The dNR was defined as the difference in millimetres (mm) between the minimum navicular height (NH) during stance and the NH at toe off. To test intra- and interday reliability, Intraclass Correlation Coefficients (ICC2.1) and repeatability were calculated. To obtain the absolute repeatability (RP) in mm, the equation RP = 1.96 × SDdifferences was used. Furthermore, the relationship between the dNR and the dND was examined by calculating Pearson (r) or Spearman (rs) correlation coefficients.Included participants showed a mean dNR of (12.2 ± 3.7) mm for level walking and (14.8 ± 3.4) mm for stair descent. The ICC2.1 for the dNR were 0.98 (intraday), 0.91 (interday) for level walking and 0.97 (intraday), 0.94 (interday) for stair descent. The interday repeatability was 3.2 mm (level walking), 2.7 mm (stair descent) respectively. For level walking, r was 0.31 (p = 0.049), and rs = 0.88 (p < 0.001) for stair descent.The dNR seems to be highly reliable (ICCs), however, repeatability is unacceptable. For level walking, the dNR might be an independent measure, but not for stair climbing.

Atopic dermatitis characteristics and medication-use patterns in school-age children with AD and asthma symptoms.

Atopic dermatitis (AD) and asthma often coexist. Both diseases can have a major impact on the lives of children with AD and their caregivers. To investigate the association of patient characteristics, comorbidities and impact of AD on children who have both asthma and AD. Children with AD (n = 140) were selected from a larger cohort of children with a reported use of asthma medication. The Children's Dermatology Life Quality Index (CDLQI) was used to assess Quality of Life (QoL), and the Self-Assessed Eczema Area and Severity Index (SA-EASI) was used to measure AD severity. Characteristics assessed included: age, sex, and the number and type of atopic comorbidities. Medication use for AD was defined using the total number of AD prescriptions, the number of different topical AD prescriptions and the highest potency topical corticosteroid (TCS) used. Determinants of AD severity and QoL were evaluated using Spearman rank tests. The following factors were most strongly associated with a lower QoL: characteristics of AD lesions (Spearman Rs = 0.61-0.69, P < 0.01), a higher SA-EASI score (Rs = 0.54, P < 0.01) and a larger number of different topical AD prescriptions (Rs = 0.38, P < 0.01). The following factors were correlated with more severe AD: age (Rs = -0.36, P < 0.01), larger number of different TCS preparations used (Rs = 0.27, P < 0.05) and larger number of TCS prescriptions (Rs = 0.25, P < 0.05). In children with asthma and AD, the number of TCS preparations used is associated with lower QoL and increased AD severity.

Internal consistency and concurrent validity of the Montreal Cognitive Assessment in individuals with major depressive disorder

This study aimed to determine the internal consistency and concurrent validity of the Montreal Cognitive Assessment (MoCA), as well as its subtests, in patients with major depressive disorder (MDD). Participants were patients with DSM-IV MDD aged between 21 and 65 years. Neurocognitive function was assessed by using the MoCA and 12 neurocognitive tests. The composite z-score of 12 neurocognitive tests, which indicated the global cognitive performance, was calculated. Participants were 57 outpatients with MDD. Except the MoCA Orientation, each of the MoCA subtests showed a wide range of scores. The average inter-item correlation and the Cronbach's alpha of MoCA were 0.24 and 0.64, respectively. The MoCA total score was significantly and highly associated with the composite z-score of 12 neurocognitive tests (Pearson's r=0.78, p<0.001). The score of each MoCA subtest was significantly and moderately correlated with the z-score of its analogous neuropsychological test (absolute Spearman's rs's=0.33−0.56, p's≤0.01). The MoCA and its subtests are reliable and valid for assessing global and specific cognitive performance in patients with MDD and could be a tool for screening neurocognitive deficits in depressed patients.

Global Progress in Road Injury Mortality since 2010.

We aimed to examine progress in global road injury mortality since the initiation of Global Plan for the Decade of Action for Road Safety 2011–2020. We examined annual percent changes in age-adjusted road traffic mortality using data from the Global Burden of Disease Study 2013. Association between changes in road traffic mortality and legislative efforts in individual nations was explored using data from Global Status Reports on Road Safety 2013 and 2015. We found that global age-adjusted mortality, both overall and for user-specific road traffic injuries, decreased significantly between 2010 and 2013 (annual percent change in rates range from -1.43% to -0.99%). Developed countries witnessed a larger decrease than developing countries in both overall and user-specific road mortality (about 2.0–4.6 times). However, there were substantial disparities within developed countries and within developing countries, with some countries seeing large reductions in mortality rates and others seeing none. The annual percent change in road traffic mortality during 2010–2013 was significantly correlated with total national law enforcement score (Spearman rs = -0.38). We concluded that results highlight the need for continued effort to reduce the burden of road injury mortality, especially in LMIC countries.

P.2.b.010 - Internal consistency and concurrent validity of the Montreal Cognitive Assessment in individuals with major depressive disorder

This study aimed to determine the internal consistency and concurrent validity of the Montreal Cognitive Assessment (MoCA), as well as its subtests, in patients with major depressive disorder (MDD). Participants were patients with DSM-IV MDD aged between 21 and 65 years. Neurocognitive function was assessed by using the MoCA and 12 neurocognitive tests. The composite z-score of 12 neurocognitive tests, which indicated the global cognitive performance, was calculated. Participants were 57 outpatients with MDD. Except the MoCA Orientation, each of the MoCA subtests showed a wide range of scores. The average inter-item correlation and the Cronbach's alpha of MoCA were 0.24 and 0.64, respectively. The MoCA total score was significantly and highly associated with the composite z-score of 12 neurocognitive tests (Pearson's r=0.78, p<0.001). The score of each MoCA subtest was significantly and moderately correlated with the z-score of its analogous neuropsychological test (absolute Spearman's rs's=0.33-0.56, p's≤0.01). The MoCA and its subtests are reliable and valid for assessing global and specific cognitive performance in patients with MDD and could be a tool for screening neurocognitive deficits in depressed patients.

Um estudo sobre a relação entre a religiosidade e o raciocínio moral dos alunos de Ciências Contábeis

Este estudo objetivou verificar a relação entre a religiosidade e o raciocínio moral dos alunos de Ciências Contábeis, para isto, primeiramente descreveu-se a religiosidade e o raciocínio moral dos indivíduos, correlacionando-os em seguida. Para mensuração da religiosidade usou-se da Escala de Maturidade da Fé, desenvolvida por Benson, Donahue, Erickson (1993). Para mensuração do raciocínio moral usou-se o Defining Issues Test -2 elaborado por Rest e Narvaez (1998). A amostra resultou de 67 alunos concluintes do curso de Ciências Contábeis de duas universidades da Paraíba, e a confiabilidade interna dos instrumentos de pesquisa foi feita través do modelo definido por Cronbach (1951). Para averiguar a relação entre a religiosidade e o raciocínio moral utilizou-se o coeficiente de correlação não-paramétrico de Spearman (rs). Os resultados evidenciaram que a maioria dos respondentes tem sua fé classificada como integrada. Quanto ao raciocínio moral, a maioria dos respondentes foi classificada no nível de manutenção das normas, o que indica que para a maioria dos indivíduos o cumprimento das leis e normas é o mais importante. Ainda sobre o raciocínio moral, quando se analisou por tipo constatou-se que a maioria dos indivíduos se enquadrara no tipo 2 (Interesse Pessoal, mas em transição), os indivíduos deste tipo quando envolvido em dilemas morais, tendem a privilegiar seus próprios interesses. No que tange a relação entre religiosidade e raciocínio moral, constatou-se que não existem evidências relevantes que a confirme, uma vez que a relação entre ambas as variáveis não se mostrou significativa.